The Diagnosis
by Lynn S M
Summary: In this prequel to Echolalia, Lois and Clark learn their younger son has autism, a diagnosis which will have major consequences for the entire family.


This story is a prequel to "Echolalia." The stories can be read in either order, although each one does have minor spoilers for the other.

Disclaimer: Jeremy, Todd, and Dr. Connolly are my own creations; all other characters mentioned herein are the property of DC Comics and Warner Brothers; I am just borrowing them for some nonprofit fun.

My thanks to my BRs Anti-Kryptonite and my BFF Margot. This story is a much different, and a much better, story for their suggestions.

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The Diagnosis

By Lynn S. M.

Rating: T for a couple of mild swear words

Submitted: August 2012

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"I'm sorry, Mr. and Mrs. Kent. Todd has autism."

The doctor's pronouncement sounded like a death knell to Clark. The son he thought he would have did not exist. Todd would never speak. Never get married. Never even have a friend. He wouldn't play baseball or attend a prom. Todd's life would be so much less than Clark had thought it would. So much less than Clark wanted for his son.

Clark set his jaw and pinched his lips into a tight line, the diagnosis tolling in his mind. Autism. He hadn't wanted to believe it.

He remembered how that word had first insinuated itself into the family.

It was Ellen who had been the first to notice something amiss. The conversation she and Lois had was burned into Clark's brain. It had occurred in the kitchen a couple of months after Todd's first birthday while Clark had been playing with Jerome in the living room. The door separating the rooms had been open, and the conversation was audible even without his super hearing.

Ellen had approached Lois with a concern and hesitation that was not at all typical of her. "Lois, have you taken Todd to see Dr. Klein lately?"

"Of course, Mother. I've taken him to all of his well-visit appointments." Although Clark could not see her, he could readily imagine Lois rolling her eyes as she said this.

"Well, maybe you should take him again, soon. He's not behaving like other children his age. He should be pointing and imitating people by now. I think you should have an expert check him out. Ask Dr. Klein to refer you to a neurologist."

"There's nothing wrong with Todd!"

"Lois, surely you've seen that his behavior is very different than Jerome's was."

As was her wont, Lois approached such an uncomfortable conversation with a frontal attack. "So, he's a little different than his brother; 'different' doesn't mean 'bad.' You always have to have something to complain about. Can't you just be happy for me that I have a wonderful family? Are you so jealous that you have to infect me with your worries?"

Clark had been surprised that Ellen didn't rise to the bait. Instead, Lois' mother took a deep, calming breath and tried again. "Lois, I'm a nurse. I've seen lots of kids and I know. Todd's not reaching his milestones. There is something wrong. And the sooner you address it, the better off Todd will be."

"Oh, so now I'm a bad mother, just because I don't rush Todd off to the doctor at your slightest whim."

Clark could tell that Ellen's store of patience had run out. He had to admit to himself that although he thought Ellen was way off-base, she was actually the one handling the conversation in a more reasonable fashion.

"That's my grandson whose life you're playing with. OK, I tried to break it to you gently, but you're just not listening. So here it is: I think Todd has autism."

"You're insane. He doesn't rock. He looks at us. He likes to be cuddled. He's nothing like autistic kids."

"Lois, I know what he does and doesn't do. I've baby-sat him enough. But I have also seen plenty of kids with autism. Not every autistic kid behaves the way you describe. Just go, have him checked out."

Clark briefly considered interrupting his game with Jerome to go into the kitchen to smooth things over: to calm Lois down and to support her against Ellen's accusations of Todd having autism. Before he had a chance to do so, however, the conversation came to an abrupt end.

"I think it's time for you to leave. Good night, Mother."

Of course as soon as the children were in bed, Lois railed aloud against her mother's advice. Clark, ever the optimist and the proud father, had fully agreed with Lois. Ellen's notion had seemed preposterous at the time.

*.*

Two sentences. Two short, simple sentences. That's all it had taken to shatter their world. Lois' mind reeled, and she looked to her husband for support. He wore an emotionless mask - his Superman "I will not show my feelings" face.

Lois' thoughts returned to their younger son. Todd had been such a happy baby. And so interactive. He used to be even more outgoing than Jerome had been at that age. He had made perfect eye contact. Smiled at people. Who could have imagined it would come to this?

Lois and Clark had both thought him a genius. Before he was even a year old, he could hand them a requested letter from an alphabet puzzle. Lois remembered that she had beamed with pride, and bragged to everyone who would listen, willingly or not, that Todd was going to win his first Kerth award at a younger age than even she had done. How could he not, when he was already showing signs of literacy far beyond his handful of months?

And it wasn't just his ability to recognize letters that was unusual. He could also pick out specified shapes from his shape puzzle before he was a year old. And not just triangles, squares and circles, but also more complex shapes such as trapezoids and hexagons.

He had apparently inherited Lois' musical abilities, as well. He was tapping his foot in perfect rhythm to songs before he was even able to cruise. Clark had been the first to see it, and at first Lois had been skeptical. After all, one of the few things that Clark did NOT do well was music. She remembered vividly the delight she'd felt when Clark put on some music and Todd proved him right.

Todd had had such a promising beginning.

Lois wondered when their son had first started showing signs of autism. She reluctantly admitted to herself that Ellen had not only been right, but she had seen the warning signs quite a while before anyone else had.

Lois had only allowed herself to believe that something was wrong a couple of months later. She had taken Todd in for his well-visit checkup and to receive his latest round of immunizations. When he got the MMR vaccine, he started screaming bloody murder. Shortly after they arrived back home, he had developed a fever. A call to the doctor had reassured her that this was not unheard of and that she should just treat it as any other fever. The fever went away in a few days, but Todd was never the same afterward. That marked the beginning of his retreat into himself.

At first, the changes had been subtle. Their elder son Jerome had started to complain that Todd wasn't smiling at him or playing with his toys anymore. Lois had dismissed the concern; she had just figured that Todd was still feeling a little under the weather and wasn't up to smiling or playing. But now she realized that Jerome, who had always been extremely close to his younger brother, had picked up on changes she herself should have seen.

The weeks that followed were among the most painful of Lois' life. Long after Todd should have recovered fully from his fever, he was showing less and less interest in the world around him. His behaviors changed in other ways, as well. He used to babble, but he ceased doing so. He lost the few words he had had. She couldn't remember the last time he had called out for Mama or Dada.

He stopped exploring his surroundings. He would just sit and stare. Well, 'stare' was putting it charitably, since his eyes were unfocussed. She could clap her hands an inch in front of his face and he wouldn't even blink.

Her once-cuddly baby now did not seem to want to be touched. If she rubbed his back, he showed no awareness of her presence. His muscles wouldn't even become more tense or lax. And if she went to give him a hug, he would whine and bat her away.

Sometime between Jerome's complaint and Todd's full deterioration, she had confided her fears to Clark.

"I think Mom may be right about Todd."

"What?"

"He's changing, Clark. We're losing him. I've been doing some reading, and I think Mom's right. I think he has autism."

"That's crazy. No one in your family has autism. And I doubt anyone in my biological family does, either; it's a human condition."

"I've been reading up on autism. There are three primary characteristics associated with it: Impaired social interaction. Check. Todd isn't even looking at us anymore. Impaired language skills. Check. He's lost his words and isn't even babbling. And restrictive and repetitive behavior. Check. He has stopped playing with his toy car by rolling it on the floor. He just holds it upside down and spins its wheels. And he has regressed into playing dump-and-fill games for hours on end. If I try to stop him, he starts to cry."

"You're reading too much into his behaviors. He's fine. You've been thinking too much about autism and now you're seeing things that aren't there. He's probably just teething. Don't the books say that that affects kids' behavior?"

"It's more than that, Clark. I'm going to take him to see Bernie tomorrow."

Clark sighed and ran his hand through his hair. "All right, honey, if it'll make you feel better. I'll go with you."

Dr. Klein had then referred them to Dr. Connolly, a pediatric neurologist. Bernie had reassured them that the assessment for autism was not invasive and wouldn't risk the discovery of Todd's mixed lineage. Autism was determined by observation of behavior, not by any blood or urine tests.

That's what had led up to today. And even though Lois had suspected that Todd was autistic, she still was not prepared for the doctor's verdict. Nothing could have prepared her for that. And her glance at Clark revealed that he was in shock as much as she. Probably more so, since he had remained in denial about the possibility through it all. She knew he had come along today simply to humor her and to show his emotional support. Of course he was too considerate to say so, but she knew him.

Lois never thought she'd ever wish to be wrong about anything, but she had indeed fervently hoped that she was wrong about Todd.

Dr. Connolly asked them if they had any questions. Clark asked the first one, "What's the cure?"

Dr. Connolly finally showed a hint of sympathy. "There is none. You might want to consider alternate living arrangements for him so that the experts can work with him and so that you can focus your attention on your other son."

Lois was outraged. The shock from the diagnosis was replaced with a firm resolve. "You mean institutionalize our baby? Like hell we will! Come on, Clark. If the 'good' doctor won't help our son, we'll do it ourselves." She left the office, dragging Todd with one hand and Jerome with the other. Clark followed quietly behind.

*.*

Clark sat in silence during the car ride home, still trying to digest the diagnosis. Autism. Incurable. Lifelong. He grimaced. He had always thought *he* wasn't normal, that he didn't really fit into society; but from what the doctor had said, he was at the very center of the bell curve compared to Todd. At least Clark could hold ordinary conversations, he knew how society expected people to behave and he was able to blend in, to pass himself off as just a regular guy. Todd would probably never be able to do any of that. Todd might be half-human, but people would see him as being more alien than Superman.

Autism. Incurable. Lifelong. There wasn't anything Clark could do about it. He had finally met a villain he was powerless against. How do you fight a foe like autism? You can't. He could do nothing to help Todd. Nothing.

Every time he glanced at Todd, he saw his own shortcomings, his own helplessness, his powerlessness. He also saw his guilt. No one in Lois' family had autism. He didn't know about his biological family. But autism had to come from somewhere, didn't it? So it had to be his fault. Either he carried the genes himself, or else the autism was caused by the interactions between human and Kryptonian genes. It had been a miracle that he and Lois could even have any kids. It probably was too much to hope that both their children would both be healthy and of sound mind.

Todd's autism was his fault, and there wasn't a damned thing he could do about it.

*.*

Lois saw Todd plop himself down in front of his shape sorter as soon as they returned home, dump it out, and proceed to put the shapes back in. Lois knew that he would stay there for hours repeating that process, if she let him. Normally, she would intervene to try to guide him into a more productive activity. But not today. Today, she was on a mission. She had been learning a bit about autism before, but now she would learn everything there was to know, and she would get her son back!

Lois was dimly aware of Clark and Jerome entering the house behind her, of Clark mechanically hanging up Jerome's coat and of him slumping into a chair while Jerome went over to Todd to try to join him in his play. Lois' mind was on the Internet searches she planned to conduct.

*.*

Superman set down the mother and daughter, then turned to the fire chief to let him know that the building was clear. After a few sentences, he flew back in to blow out the fire.

He left the scene as soon as he could. The girl couldn't have been much older than Todd, but even their brief interaction showed that she could do so much more than Todd could. She had made eye contact with Superman. She had smiled at him and waved goodbye when he took off. She interacted more with him in those few minutes than his own son had in months.

That nonverbal exchange had been sheer agony. But as painful as that interaction had been, at least Clark knew he had saved her life and that of her mother. He was able to do good for them. Thanks to him, they would be able to go on to have full lives. Normal lives. He was able to make a positive difference.

He wished he could do something for his son, but he knew he couldn't. And every time he saw Todd, it was a knife to his heart. His son needed help that he couldn't give. His heart ached for his son, but he could do nothing for him.

He had been spending more and more time lately on Superman duty; he might not be able to help his son, but at least his caped persona could help other people. Performing rescues helped him to feel a little less powerless.

A part of him felt guilty for abandoning Lois so much of the time, but he reasoned with himself that even when he was home, they didn't exactly spend time together. She was too busy investigating autism online in the hopes of finding something they could do to help Todd. He couldn't really blame her; after all, she was just doing what he was - trying to find some way to help, some way to feel that she was making a difference. He hoped that she could find something useful in her research. But the neurologist had said that autism was incurable and lifelong; if the expert didn't know of any cures, how likely would it be that Lois would find one on the Internet?

Clark concluded that Superman had been busy long enough this evening. Time to return home.

*.*

Lois was drained. Every moment in the past three weeks that she wasn't busy with her reporting or with taking care of Jerome and Todd had been spent researching autism. She had read websites until her eyes glazed over, placed phone calls to schools, therapists, insurance companies, government agencies, and a wide range of businesses claiming to help children with autism. Although she had learned a lot, she was left with more questions than she had had to begin with.

There was so much still unknown about autism. What caused it. Whether it could develop after birth or whether it was congenital even in cases where the more obvious symptoms didn't manifest themselves until the child was months or even years old. Whether there even was one single cause. Whether it was possible to recover from it. What the prognosis for a given child might be. Whether it was becoming more common, or even what the prevalence of it currently was. What the physical manifestations of autism were. Seemingly simple questions that often resulted in highly charged debates with no definitive answers.

She wished she could talk to Clark about it, but he had been spending almost all of his non-work time in the Suit.

She heard the familiar whoosh of Clark's return. He closed the bedroom window and spun into his black silk pajamas.

Lois fought the growing resentment she felt toward him. Once again, he had returned only after Todd and Jerome were in bed. He hadn't seen his sons awake for more than three hours in as many weeks. For that matter, he hadn't even seen Lois awake outside of work much more than that.

Clark commented, "That fire was nasty, but I managed to rescue the building's residents before they were hurt."

Lois snapped, "Jerome and Todd had a good evening. I did, too. Thanks for asking."

Clark's shoulders stiffened and he bit out, "What's your problem?"

"You are. You're never here."

"You knew I was Superman when you married me. I thought you understood that I'd have to leave you alone when somebody needed me."

"I do. I do understand that. Really. But I thought you understood that being a father means juggling your responsibilities. And you *did* understand that right up until Todd was diagnosed. But in the past three weeks, you've been as bad as you were back when I turned down your proposal. You 're hiding in your cape. You're trying to escape the reality of Todd's autism by rescuing other people. Try helping rescue your own son!"

Clark's voice became low in both pitch and volume. "You think I don't want to? You think I wouldn't help Todd if I could? If I could give up my life in exchange for making him normal, I'd do it in a heartbeat. But I can't. Don't you see that? There's *nothing* I can do to help him. And that hurts. So, yes. I am helping the people I can help. I'd rather help Todd, but I can't fly in and snatch him from the jaws of autism. And it's hard. It hurts more than anything else ever has."

Lois wanted to rail at him that Todd needed him. That *she* needed him. Jerome, too, for that matter. And he had abandoned all of them. She wanted to scream that she was hurting, too, and not only could she not fly off, she had to pick up the slack he left every time he flew out the window.

She realized that she had already started to let Mad Dog Lane out on a rampage; a part of her wanted to continue in that vein. But she knew that that approach wouldn't help. One thing she had learned in her years of marriage and motherhood was that one needed to pick one's battles very carefully, and to consider the long-term effects of one's actions. Although yelling at Clark right now would certainly be satisfying, it wouldn't solve any of their problems; it would only add to them.

So she just stood still, breathing deeply until she could master her emotions a bit. She then put her hand on one of Clark's folded arms and looked him in the eyes. She forced herself to speak in a gentle voice. "I know you're hurting. I am, too. But you're wrong. Dr. Connolly was wrong, too. There *are* things we can do to help Todd. They won't be as easy or as fast as rescuing someone from a burning building, and they won't all work, but we can help Todd get the most out of life. He may never fully recover, but he can improve."

Lois thought she caught a glimmer of hope in Clark's eye, but his voice remained skeptical. "What can we do?"

"There are all sorts of therapies out there. Applied Behavioral Analysis. Sensory Integration Therapy. Special diets. Biomedical interventions. Patterning. Massage therapy. Secretin. Some of the stuff being hyped looks like snake oil to me, but there is scientific evidence for Applied Behavioral Analysis. And some of the alleged therapies seem to have a lot of anecdotal support.

"But I could really use your help. There's so much information and misinformation out there that it would take me months to read it and sort it all out. And one of the few things that pretty much everyone agrees on is that the earlier positive interventions are started, the better.

"Think you could do some super-fast reading and let me know what you find out? There's no way we could afford all of the therapies, even if we did want to try them all. Most aren't covered by insurance, and a lot cost thousands of dollars each."

Clark's eyes regained a spark she hadn't seen in them for a very long time.

*.*

That discussion was a turning point for the whole family. With Clark's speed-reading ability, he quickly surpassed Lois in terms of autism-related knowledge. He also read a few books by Temple Grandin, and encouraged Lois to read them, as well. Dr. Grandin started life as affected by autism as Todd, but she grew up to earn a doctorate in animal science and became a successful entrepreneuse. The more-humane cattle chutes she had designed were used in slaughterhouses throughout the country. She also was a nationally-renowned speaker who gave presentations at both animal husbandry and at autism conferences. She invented a "squeeze machine" that many people on the spectrum found calming. And although her personal life seemed pretty barren to Clark (she did still have autism, after all, and she seemed to prefer the company of animals to that of other people), she herself felt that she had a satisfying life. And really, Clark realized, it was her own opinion of her quality of life that mattered, not his. Clark knew that Dr. Grandin's successes were not at all typical of people on the spectrum - or of neurotypical people, for that matter - but that she was able to accomplish so much and have such a fulfilling life showed that it was possible for someone with autism to do so. There was hope for Todd, after all.

Lois and Clark explored the myriad of interventions for autism and chose several to pursue. Some didn't seem to yield any results, others yielded such minimal results that they were set aside to free up their temporal and monetary resources for more effective treatments. Progress was painfully slow, but it was real.

Several months had passed since they had started trying various interventions; they tried a new one every three weeks or so, and they were a few days into their most recent intervention. Clark had just finished spending an hour or so engaging in floortime with Todd. ("Floortime" had been one of their earlier interventions which had been proving successful enough for them to continue indefinitely.) When Todd settled down to play a solitary dump-and-fill game, Clark asked Jerome to join him for a game of checkers. (Clark knew that siblings of kids on the spectrum often got short shrift in terms of their parents' time, and he was determined not to let that happen with Jerome.) While they were playing, they talked about everything from how hard Jerome's math class was to the latest antics of his friend Joe. Their conversation was accompanied by the plop, plop, plop of plastic shapes being dropped into Todd's shape sorter, followed by the sound of the pieces being dumped from the shape sorter back onto the floor so that Todd could begin putting them back in again.

After about 15 minutes, Clark was alerted by the quiet that Todd had stopped playing with his shape sorter. Clark immediately looked up to see Todd standing. Clark watched to make sure that his younger son wasn't going to get into any mischief; he certainly didn't want a repeat of the previous week's spice-dumping incident. But instead of heading toward the kitchen, Todd approached Jerome's chair and reached his little arms around his brother to give him a quick hug. He scampered off almost before Clark realized what had happened, let alone before Jerome could turn around to reciprocate the hug.

Clark was stunned; a part of him didn't dare believe what he had seen. That had been the first hug that Todd had given anyone in months. It made Clark realize how much Todd was once again interacting with his environment and even with people. Clark couldn't wait until Lois got home to share the news with her.

Clark saw that the hug had affected Jerome as much as it had himself. His older son was smiling, but his eyes were moist. After a minute, Jerome managed to say, "He hugged me, Dad."

"Yes, son, he did."

Clark knew that their whole family had many years of challenges and hard work ahead of them. He didn't know how much progress Todd would make, or whether he would ever be able to live independently. But he now knew that it was possible that the sky was the limit; their affectionate son was starting to come back to them.

The satisfaction Clark found in rescuing strangers was nothing compared to the joy he felt in being able to help his own son. He mentally paraphrased an old commercial: Parenting was the toughest job he'd ever love.

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As you may have surmised, much of this story is at least partially drawn from my own life. This includes some of the seemingly-outrageous abilities of the very young Todd. My son was indeed able to identify complex shapes, ranging from trapezoids and hexagons to letters of the alphabet, before he was a year old. He also was able to tap his foot to music before he could even stand without support.

I have tried numerous medical, dietary, and behavioral interventions with my son; some have shown dramatic results, others no results whatsoever. Although Andy is still extremely affected by autism, he is far from the zombie he had been at his worst. The greatest improvement came precisely three days after we started the first intervention - putting him on a gluten-free, casein-free diet. That was when he gave me the first hug he had given anyone in months. I haven't the words to describe how powerful that moment was for me, but I wrote this story in part to try to convey both the depths of helplessness I had felt leading up to that point and the elation that can result from a simple hug. (Incidentally, I had been fortunate in that my son's neurologist pointed me to Temple Grandin's books right after he confirmed Andy's diagnosis of autism.)

I discovered that, as mentioned in the story, there are a plethora of therapies available which range from very beneficial to pure quackery; many are in a grey area somewhere in between. Please do not assume that inclusion of a therapy in this story is an endorsement of that therapy; I tried to mention therapies of varying effectiveness to keep the story more true to life. Also, what helps one child might not help another. The two pieces of advice that I think everyone in the autism community would agree upon are: 1) Do your research, and 2) Start as early as possible whatever interventions your research leads you to believe are appropriate. (Well, actually, it is best to stagger the starts of interventions so that you would have a better idea of which one was proving to be effective.) The importance of early intervention cannot be overstated.

Please note that, while I have tried to be at least somewhat balanced in this story, I have touched upon several very controversial topics. Among them, whether vaccine injury causes or contributes to the severity of autism in at least some cases, whether biomedical interventions are effective, to what extent environment vs. genetics is responsible for autism, and even whether people with autism should be seen as having a medical condition which should be treated/alleviated as much as possible or whether they should instead simply be respected as having neurological differences. I'm sure my views on at least some of these topics will be easy to discern, but I did try to be fair to "the other side" in each issue.

Also be aware that Dr. Connolly was a bit old-fashioned; his advice to institutionalize Todd would have been more likely to have been given by a doctor decades earlier, when it was thought that autism was caused by "refrigerator mothers." (shudder. Thank God we've come a long way since then.)

**References**

2003-05-14/news/17491408_1_autistic-children-autism-neurodevelopmental-disorders

I am purposely refraining from posting references to any interventions, but I would be more than happy to share those with anyone who asks. Also, if you would like to know more about autism or what it is like for me to raise a child on the spectrum, I would be happy to answer any questions.

As always, all feedback welcomed.


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